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Valproate During Pregnancy Linked to Children with Lower IQs

Apr 16, 2009 | Parker Waichman LLP

Valproate (sold under the brand names Depacon and Depakene) taken during pregnancy may cause children to have lower IQs, according to a new study published in The New England Journal of Medicine.  According to a report on Reuters.com, toddlers exposed to valproate in utero had IQs that were 6 to 9 points lower than children whose mothers took other epilepsy medications.

vesicant processing  Just last December, we reported that a British study had found that children whose mothers had taken valproate during pregnancy were seven times more likely to develop autism than those not exposed to any epilepsy medication.  The increased risk was not seen with other epilepsy drugs included in the study.

Another study published in Neurology last year found that women taking valproate along with the migraine medication Topamax were 11 times more likely to give birth to a baby with birth defects than those taking Topamax alone.  Defects seen in that study included genital birth defects in male babies, a hole above the buttocks, a flattened head, toe webbing, clicky hips and immature hip joints.

Previous research has also shown that valproate is associated with an increased risk of birth defects such as heart defects and spina bifida.

According to the Associated Press, researchers in the Emory study followed pregnant women in the United States and United Kingdom between 1999 and 2004. The results are based on about 260 of their children. The average IQ of toddlers born to women who took valproate was 92, while the scores of those exposed to other epilepsy drugs, including lamotrigine, phenytoin, and carbamazepine, ranged from 98 to 101.  An IQ of 100 is considered average.

The higher the dosage of valproate a woman had taken, the lower the IQ of the child, the researchers found. For the other drugs, dosage levels made no significant difference.

The implications of this study are important.  According to Reuters.com, about 25,000 babies are born to epileptic mothers every year.  If a pregnant woman takes valproate, it is often because it is the only drug that works for her.  

An editorial accompanying the Emory study in the New England Journal of Medicine advised that women taking valproate who want to get pregnant should plan their pregnancies carefully and consult with a doctor.  Switching drugs after a woman realizes she is pregnant is unlikely to reduce the risk of birth defects. And abruptly stopping the medication may endanger the mother and the fetus, the editorial said.


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